Ep 180 – Rethinking HIV: reducing HIV-related stigma

In this final episode of a four-part series on HIV and primary care, Dr James Waldron is joined again by Dr Grace Bottoni (HIV and Hepatitis C GP Champion, Lewisham) and special guest Darren Knight (CEO of George House Trust). Together, they explore the importance of language in healthcare and how reducing HIV-related stigma is key to increasing engagement with primary care, improving lives and helping to prevent HIV transmission. This conversation brings together clinical insight, lived experience and practical strategies for making HIV care truly inclusive.

Key take-home points

• Language shapes care; we should use person-centred terms such as “living with HIV” instead of “infected with” and “sharing status” rather than “disclosing status”.
• Stigma still exists despite medical advances, and negative attitudes (especially in healthcare) remain a major barrier to engagement.
• The message that "U=U" ("undetectable equals untransmittable") matters. Knowing it is not sufficient; healthcare teams must believe it and apply it in practice.
• Patients who feel judged or unwelcome may disengage from care, worsening outcomes and increasing transmission risk.
• HIV can affect anyone and is not limited to certain groups; assumptions about transmission routes can fuel prejudice.
• HIV should be managed like other long-term conditions, with consistent, holistic care across the whole practice team.
• Education can change culture, and resources can help shift attitudes and normalise HIV care in primary care settings.
• Primary care plays a central role: from opt-out testing to inclusive policies, GPs and practice staff are key to reducing stigma.
• Safe spaces encourage disclosure. When trust and confidentiality were assured, more than 90% of people surveyed wanted their GP to know their HIV status.
• By removing stigma from healthcare interactions, we can help reduce transmission of new infections and, in turn, improve public health.

Related references and resources

1. George House Trust. https://ght.org.uk.
2. HIV Confident. https://hivconfident.org.uk.
3. Terrence Higgins Trust. https://tht.org.uk/.